Opinion | O.C.D., My Exhausting Best Friend – The New York Times

I obviously need a new best friend.

Most people wouldn’t guess that I’m constantly tortured by disturbing thoughts. I’ve hosted live TV shows and given speeches in front of large audiences. During the LSAT, a few friends from college sat next to me because they said I had a calming energy. They had no idea of the internal storm always raging in my mind.

As far as acting on my thoughts and fears, I don’t: I’m possibly the most boring man on earth. I’m married with kids, don’t drink or get into bar fights. This makes sense. “Themes of O.C.D. have no absolutely no implication about the character of a person,” Dr. Phillipson said.

David Adam, author of the memoir “The Man Who Couldn’t Stop,” told me, “O.C.D. makes everything harder.” His book describes how he confronted his own O.C.D., which involved an intense, irrational fear of contracting H.I.V. We agreed that O.C.D., like all mental health afflictions, is not an artistic muse or creative gift but is ultimately unfair, with no complimentary benefits. Even though he likens his condition to being a recovering alcoholic, Mr. Adam was thankfully able to treat his O.C.D. and eventually write two books after he did a form of behavioral therapy called exposure and response prevention.

This is the most successful treatment for O.C.D., and it involves repeated exposure to the fearful thoughts without giving into the short-term relief delivered by compulsions. The trick is that you can’t outthink the disorder, you can’t outargue it, you can’t outrun it. You have to make the voluntary choice to confront it. It’s like inviting Pennywise the Clown, the demon from Stephen King’s “It” who feeds off your fears, over for a nice cup of tea. For example, if you’re obsessed with germs and contamination, then you have to abandon your compulsions and instead use public toilets and avoid repeatedly washing your hands. You choose to sit with the threat. Eventually, your brain habituates to the threat and is even bored by it, realizing there is nothing to fear.

Dr. Phillipson said people should first choose to forgive themselves for having O.C.D. If everyone had our misfiring brains, the whole world would behave exactly like us. Second, he advised against using negative imagery and instead welcoming our “best friend’s warning” but then choosing to ignore it. “The goal of the treatment is to make the thoughts irrelevant,” he said, “it’s not to make the thoughts go away.”

O.C.D. has exhausted me. I’m tired of suffering. I’m now doing exposure and response prevention, voluntarily exposing myself to my fears. It’s terrifying and often excruciating, like walking through a gantlet of horrors without a shield or sword, armed only with belief and resolute conviction.

All the while, I’m working to abandon shame and guilt about my mental health disorder and to embrace the “best friend” I didn’t ask for.

Wajahat Ali (@WajahatAli) is a playwright, lawyer and contributing opinion writer.

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